Please complete all sections. Click the Submit button to continue. Universal Intermodal Credit RequestTerminal*Line Of Credit Requested*Is This For A Broker*- Select -YesNoEmail* Load InformationLoad Date* Load Revenue*Number Of Loads*Per*- Select -DayWeekMonthCommodity*From CompanyFrom LocationTo CompanyTo LocationCredit Check Requested ForBusiness Name*Phone*Fax*Broker MC #*DUNS #*Address Line 1*Address Line 2City*State/Province*Zip*Contact*Federal Tax ID Number*Years In Business*Has the firm or any of its principals ever filed bankruptcy?*- Select -YesNoEDI Capable?*- Select -YesNoEFT Capable?*- Select -YesNoAuto Pay?*- Select -YesNoRequired Customer Documentation For Freight Payment* Bill Of Lading Load / Reference Number Copy Of Permits Copy Of Scale Tickets CommentsReferencesReferences available if requested?*- Select -YesNoCarrier ReferencesNameAddressPhoneNameAddressPhoneNameAddressPhoneBank ReferencesNameAddressPhoneAccount NumberContactCAPTCHA